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Clinical Toxicology

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https://www.readbyqxmd.com/read/28814126/detection-of-ingested-nitromethane-and-reliable-creatinine-assessment-using-multiple-common-analytical-methods
#1
Christine M Murphy, John J Devlin, Michael C Beuhler, Paul Cheifetz, Susan Maynard, Michael D Schwartz, Sherri Kacinko
AIM: Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation...
August 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28814125/recreational-drug-use-at-a-major-music-festival-trend-analysis-of-anonymised-pooled-urine
#2
Lotte Christine Groth Hoegberg, Cecilie Christiansen, Jesper Soe, Rasmus Telving, Mette Findal Andreasen, Dan Staerk, Lona Louring Christrup, Kenneth Thermann Kongstad
OBJECTIVE: The spread of new psychoactive substances (NPS) has expanded rapidly in the last decade. The complexity of the pharmacological effects of NPS challenges the traditional treatment guidelines, and information of the emergence of new arrivals is valuable. Our knowledge on the actual range of recreational drugs used and NPS available in Denmark is limited as identification is possible only when consumers become patients in the healthcare system or through drug seizures. We aimed to detect classical recreational drugs and NPS in the urine of music festival attendees and evaluate if the use of NPS could have been predicted by comparing study data with drug seizure data from the previous year published by European and Danish health authorities...
August 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28814122/flibanserin-toxicity-in-a-toddler-following-ingestion
#3
Nicholas Granzella, Betty C Chen, Geoffrey S Baird, Matthew Valento
INTRODUCTION: Flibanserin is a medication recently approved by the FDA for treatment of generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Its mechanism of action is not fully understood but is thought to modulate serotonin receptors and increase levels of norepinephrine and dopamine. While much is known about toxicity of other drugs which affect these systems, there is little information about toxicity of flibanserin at this time. CASE: We present a case of a 2-year-old boy who ingested an estimated 600 mg of his mother's flibanserin...
August 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28814119/correction-to-north-american-congress-of-clinical-toxicology-nacct-abstracts-2017
#4
(no author information available yet)
No abstract text is available yet for this article.
August 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812394/the-use-of-sustained-low-efficiency-dialysis-sled-in-massive-paracetamol-overdose
#5
Anselm Wong, Roger L K Tong, Liam Ryan, Tim Crozier, Andis Graudins
CONTEXT: Massive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. CASE DETAILS: A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812385/increased-acetaminophen-related-calls-to-finnish-pic-better-reflect-acetaminophen-sales-than-serious-poisonings
#6
Mikko J Parry, Helena Isoniemi, Anna-Maria Koivusalo, Kalle Hoppu
OBJECTIVE: Acetaminophen (APAP) or paracetamol is a commonly encountered medicine in poisonings. We studied the changes in APAP related calls to the Finnish poison information centre (FPIC), and serious intoxications, involving hepatotoxicity or death in 2001-2014. These data were compared with paracetamol sales in Finland. METHODS: This is a retrospective analysis of the FPIC database calls, national cause of death registry, registries of liver transplantations and molecular adsorbent recycling system (MARS)-treated patients from Helsinki University Hospital together with the National Institute of Health and Welfare registry of patients hospitalized...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812383/evaluation-of-relationship-between-coronary-artery-status-evaluated-by-coronary-computed-tomography-angiography-and-development-of-cardiomyopathy-in-carbon-monoxide-poisoned-patients-with-myocardial-injury-a-prospective-observational-study
#7
Yong Sung Cha, Hyun Kim, Yoonsuk Lee, Woocheol Kwon, Jung-Woo Son, Hyun Youk, Hyung Il Kim, Oh Hyun Kim, Kyung Hye Park, Kyoung-Chul Cha, Kang Hyun Lee, Sung Oh Hwang
OBJECTIVES: Whether coronary artery changes are a main mechanism in the development of carbon monoxide (CO)-induced cardiomyopathy remains unknown. We investigated the effects of coronary artery stenosis on the presence or patterns of cardiomyopathy in CO-poisoned patients with myocardial injury defined as elevation of troponin I. MATERIALS AND METHODS: This prospective observational study collected data from consecutive patients who were diagnosed with CO poisoning and myocardial injury during the 24-month study period...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812382/can-elevated-lactate-and-ldh-produce-a-false-positive-enzymatic-ethanol-result-in-live-patients-presenting-to-the-emergency-department
#8
Nicholas Nacca, Michael J Hodgman, Kirselle Lao, Matthew Elkins, Michael G Holland
BACKGROUND: There have been allegations in the courtroom that elevated serum lactic acid in trauma victims can yield a falsely elevated serum ethanol assay. Most hospitals utilize an indirect method of ethanol measurement where a serum sample is added to a mix of alcohol dehydrogenase and oxidized nicotinamide adenine dinucleotide (NAD+). This allows any ethanol in the patient's serum to be metabolized to acetaldehyde, and in the process results in the reduction of NAD + to NADH. NADH is then measured using spectrophotometry...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#9
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812380/analysis-of-an-8-hour-acetylcysteine-infusion-protocol-for-repeated-supratherapeutic-ingestion-rsti-of-paracetamol
#10
Anselm Wong, Naren Gunja, Richard McNulty, Andis Graudins
OBJECTIVES: In Australia, the treatment guideline for patients with repeated supratherapeutic ingestion (RSTI) of paracetamol recommends an abbreviated acetylcysteine regimen if the paracetamol concentration is low (<10 mg/L) and alanine aminotransferase (ALT) is normal or static after 8 hours of infusion. There are currently no studies of this recommendation. METHOD: A retrospective review of paracetamol overdose presentations from October 2009 to August 2016 in two hospital toxicology networks was performed...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28756689/recreational-use-of-carfentanil-a-case-report-with-laboratory-confirmation
#11
Sabine Müller, Susanne Nussbaumer, Gabriel Plitzko, Roger Ludwig, Wolfgang Weinmann, Stephan Krähenbühl, Evangelia Liakoni
No abstract text is available yet for this article.
July 31, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28756680/correction-to-toce-et%C3%A2-al-a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#12
(no author information available yet)
No abstract text is available yet for this article.
July 31, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28756679/accuracy-of-the-paracetamol-aminotransferase-product-to-predict-hepatotoxicity-in-paracetamol-overdose-treated-with-a-2-bag-acetylcysteine-regimen
#13
Anselm Wong, Marco L A Sivilotti, Naren Gunja, Richard McNulty, Andis Graudins
INTRODUCTION: Paracetamol concentration is a highly accurate risk predictor for hepatotoxicity following overdose with known time of ingestion. However, the paracetamol-aminotransferase multiplication product can be used as a risk predictor independent of timing or ingestion type. Validated in patients treated with the traditional, "three-bag" intravenous acetylcysteine regimen, we evaluated the accuracy of the multiplication product in paracetamol overdose treated with a two-bag acetylcysteine regimen...
July 31, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28753074/acute-pneumonitis-associated-with-nickel-carbonyl-exposure-in-the-workplace
#14
Nena Bowman, E Martin Caravati, B Z Horowitz, Barbara Insley Crouch
BACKGROUND: We describe the clinical course of one industrial technician occupationally exposed to nickel carbonyl (NiC). CASE REPORT: A 50-year-old male industrial technician presented with complaints of nausea, myalgia, and cough to a local clinic after suspected occupational exposure to nickel carbonyl. He has no history of lung disease or smoking. His initial urine nickel concentration was 692 ug/L. He had infiltrates on the initial chest X-ray (CXR) and an oxygen saturation (O2) of 97% on room air...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28753048/initial-diffusion-weighted-mri-and-long-term-neurologic-outcomes-in-charcoal-burning-carbon-monoxide-poisoning
#15
J M Moon, B J Chun, B H Baek, Y J Hong
CONTEXT: This study assessed the results of diffusion-weighted imaging (DWI) at presentation for acute charcoal-burning carbon monoxide (CO) poisoning and investigated whether the initial DWI results can predict long-term neurologic outcomes. METHODS: The study included 128 patients who suffered from CO poisoning after burning charcoal and underwent DWI. These patients were divided into two groups based on imaging results: a normal DWI group and an abnormal DWI group...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28753046/levetiracetam-in-toxic-seizures
#16
Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28753045/an-internet-based-survey-of-96-german-speaking-users-of-bath-salts-frequent-complications-risky-sexual-behavior-violence-and-delinquency
#17
Sabrina Schmoll, Katrin Romanek, Raphael Stich, Elias Bekka, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To define the demographics of German-speaking "bath salt" users. DESIGN: Prospective web-based survey of volunteer users of "bath salts". Subject recruitment/exclusion: Participation was solicited by posts in web forums frequented by users of synthetic cathinones. An invitation to participate was also disseminated via regional drug information centers. Responses were discarded if participants refused data analysis, provided incomplete surveys, were under 18 years of age (five cases), and in case of clearly improbable answers (i...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28753044/severe-bark-scorpion-envenomation-in-adults
#18
Ayrn D O'Connor, Angela Padilla-Jones, Anne-Michelle Ruha
INTRODUCTION: The preponderance of medical literature regarding severe bark scorpion envenomation describes pediatric patients; however, the majority (>66%) of annual poison center calls pertain to adults. This retrospective review sought to evaluate the clinical manifestations of adults with severe Centruroides sculpturatus envenomation and determine if significant morbidity occurred. METHODS: This is a retrospective review of adults presenting to a single tertiary referral center with Grade-III or Grade-IV scorpion envenomation from 1 January 2007 to 3 March 2013...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28748745/histamine-poisoning-from-insect-consumption-an-outbreak-investigation-from-thailand
#19
Summon Chomchai, Chulathida Chomchai
BACKGROUND: Insect consumption is a common practice in the Asian culture and all over the world. We are reporting an outbreak investigation of histamine poisoning from ingestion of fried insects. METHODS: On 24 July 2014, a group of students at a seminar presented to Angthong Provincial Hospital, Thailand, with pruritic rash after ingesting snacks consisting of fried insects from a vendor. We initiated an outbreak investigation with retrospective cohort design and collected samples of remaining foods for analyses...
July 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28748717/in-response-to-balancing-the-risks-and-benefits-of-medication-organizers
#20
George Sam Wang, Jason Hoppe, Lina Brou, Kennon Heard
No abstract text is available yet for this article.
July 27, 2017: Clinical Toxicology
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